Pattern and presentation of carcinoma stomach

To determine the clinical profile of carcinoma stomach.

A case series.

A single unit of the Department of General Surgery, Dow University of Health Sciences and Civil Hospital, Karachi, from April 2006 to April 2010.

Patients with gastric cancer confirmed on histopathology were included in the study. Patients diagnosed with acid peptic disease and benign gastric ulcer were excluded. Variables studied were, age, gender, mode of presentation, presenting complain, endoscopy findings, palpable supraclavicular lymph node, histopathology, stage and treatment. Data was analyzed for descriptive statistics.

Total number of patients were 15, include 9 males (60%) and 6 females (40%); male female ratio was 1.5:1. Mean age was 48.6, ± 4.47 years, ranging from 26-65 years. Majority of the patients (n=9, 60%) were presented through outpatient department, while the rest presented through emergency. Common presenting complains were vague upper abdominal pain, mass, ascites, peritonitis and hematemesis. On endoscopy tumour was found at the cardiac end in 5 patients (33%), at pylorus and antrum in 6 patients (40%), linitis plastica in 2 patients (13.3%), only body and body and pylorus were involved in 1 patient (6.7%) each. Ten patients (66.6%) presented at stage IV and 3 patients (20%) in stage III. Surgical resection was possible in 5 patients (33.3%). Total gastrectomy was performed in one patient (6.7%), while subtotal gastrectomy was undertaken in 4 patients (26.7%). Palliative gastrojejunostomy was performed in 4 (26.7%) and feeding gastrostomy and endoscopic stenting in 2 patients (13.3%) each. Chemotherapy was given to 8 patients (53.3%) patients while radiotherapy to 2 patients (13.3%). Histopathological diagnosis was diffuse infiltrating adenocarcinoma in 10 (66.6%), infiltrating intestinal type in 3 (20%) and gastric lymphoma in 2 (13.3%) patients. Mortality was 13.3%.

Majority of the patients with gastric carcinoma were young males, presenting with advanced stage disease. Only 33% tumours were resectable while 53.3% tumours were managed by palliative treatment. Overall mortality was 13.3%.